US Supreme Court preserves access to abortion pill: What was the case, and what the court said

“The plaintiffs do not prescribe or use mifepristone,” Justice Kavanaugh wrote. “And FDA is not requiring them to do or refrain from doing anything… A plaintiff’s desire to make a drug less available for others does not establish standing to sue.”

The verdict has preserved access to mifepristone in the US for now. The court, however, has kept the doors open to other attempts to limit the availability of the drug.

The development has come nearly two years after the apex court of the US overturned Roe v. Wade, which effectively repealed a federal right to abortion.

Here is a look at the case, the pill, and the ruling.

What was the case?

In 2022, four pro-life medical associations, as well as several individual doctors, sued the FDA in the US District Court for the Northern District of Texas. The petitioners had challenged the FDA’s approval of mifepristone and the changes the federal agency made in the pill’s conditions of use — the modification broadened mifepristone’s distribution through mail and telemedicine (the provision of remote clinical services).

“The plaintiffs claim that mifepristone is unsafe and that the agency’s approval process for the drug was flawed,” according to a report by The New York Times.

In April 2023, federal judge Matthew J Kacsmaryk held that the FDA’s approval of the drug should be suspended, removing mifepristone from the market.

Subsequently, an appeals court in New Orleans overturned this ruling partially to the extent that it invalidated the FDA’s approval of the pill. It also imposed restrictions on the pill’s distribution, including prohibiting sending the medication by mail or being prescribed by telemedicine.

However, the Supreme Court put the appeals court’s ruling on hold and agreed to hear the case.

What is mifepristone?

Mifepristone is part of the two-drug regimen used for medical abortion. A patient first takes mifepristone to induce an abortion and then misoprostol to empty the uterus.

While mifepristone blocks progesterone — a hormone that supports menstruation and maintaining a pregnancy — misoprostol triggers uterine contractions, causing the body to expel the pregnancy as in a miscarriage.

The regimen was approved for use up to 10 weeks of pregnancy by the FDA in 2000. Since then, more than six million people have used mifepristone for abortion. Currently, the pill is used in about two-thirds of abortions in the US.

Studies have found the pill to be safe, and years of research have shown that serious complications are rare.

What did the court rule?

To reject the petition by the anti-abortion groups and individual doctors, the Supreme Court cited the “personal stake requirement” laid down in one of its 1982 judgments. The personal stake requirement basically means that the party seeking relief has to have a “personal stake in the outcome of the controversy.”

The appellant should show that they have suffered or been threatened with some distinct and palpable injury. There must also be some causal connection between the appellant’s asserted injury and the defendant’s challenged action.

The Supreme Court found that the doctors and medical associations trying to challenge the FDA’s regulation failed to show an actual injury because the plaintiffs didn’t include people actually involved with the pill, like doctors prescribing mifepristone or pregnant women who took it. It said the plaintiffs could not show any harm suffered from mifepristone’s availability.

In the judgment, the top court also said that federal courts do not operate as an open forum for citizens “to press general complaints about the way in which the government goes about its business”.